Risk Factors

Body composition determines cancer risk


The ratio of abdominal fat to peripheral fat is a significant independent predictor of a cancer diagnosis in postmenopausal women, according to a large Danish study.

The Prospective Epidemiologic Risk Factor study followed 5,855 postmenopausal women who underwent baseline dual-energy X-ray absorptiometry scans to assess their body composition.

The study, presented at the ESMO 2017 Congress, recorded 811 solid cancers during 12 years of follow-up including 293 breast and ovarian cancers, 345 lung and gastrointestinal (GI) cancers, and 173 other cancers.

Trunk fat, but not BMI or fat percentage, was an independent predictor of cancer incidence (HR 1.34). When analysed by cancer type, women with a high abdominal fat ratio had more than a 50% increased risk of developing lung and GI cancers than women with a low ratio (HR 1.52).

The association was independent of additional cancer risk factors such as older age, hormone replacement therapy and smoking.

Study investigator Line Mærsk Staunstrup, from the Nordic Bioscience and ProScion, in Herlev, Denmark, said the higher level of abdominal adiposity in menopausal women may mediate obesity-related cancer risk.

“The average elderly woman can very much use this information, as it is known that the menopause transition initiates a shift in body fat towards the central trunk area. Therefore elderly women should be especially aware of their lifestyle when they approach the pre-menopause age.”

“Avoiding central obesity may confer the best protection.”

“Clinicians can additionally use the information for a preventive conversation with women who are at higher risk of cancer,” she said.

“When assessing cancer risk, body mass index and fat percentage may not be adequate measures as they fail to assess the distribution of fat mass.”

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